The present invention relates to an apparatus and method for acquisition and retrieval of resected biological specimens. More specifically, the present invention is concerned with a vacuum mouthpiece for the acquisition and retrieval of resected biological specimens from a body cavity, a self-closing pouch for entrapment and retrieval of resected biological specimens from a body cavity, and a laparoscopic system incorporating such a mouthpiece and such a pouch.
Laparoscopy, also known as xe2x80x9ckeyhole surgery,xe2x80x9d is today increasingly complementing and even replacing conventional surgery, especially in the abdominal region, for resection and removal of diseased organs such as a gall bladder, ovaries, or diseased parts of such organs, cysts, and the like. The small incisions required for laparoscopic procedures minimize skin scarring, reduce the risk of infection, and greatly speed up would healing.
Laparoscopic devices for the removal of resected specimens are known, most of which are based on the use of a pouch and propose ways of closing that pouch with the specimen inside it, such as a drawstring thread (U.S. Pat. Nos. 5,647,372 and 5,465,731) as well as grasping means to control the pouch edges, but do not address the cardinal issue of getting hold of the resected specimen, putting it into the pouch, and withdrawing it from the body cavity.
U.S. Pat. No. 5,480,404 teaches a belt-like loop with a flexible pouch which enables the scooping up of the specimen, closing the pouch and removing it from the body cavity. This disclosure too, only partially resolves the issue of xe2x80x9ccatchingxe2x80x9d the specimen, and does not deal satisfactorily with the withdrawal of the specimen from the body cavity.
Instead of a pouch, U.S. Pat. No. 5,176,687 uses a flexible membrane which has a collapsed and an expanded state, but it does not deal with the retrieval of the specimen.
U.S. Pat. No. 5,215,521 discloses an envelope sheath to entrap the resected specimen as well as a morcellator allowing for safe morcellation of the specimen, and provides both for the catching and the retrieval thereof, but the apparatus and auxiliaries described are highly complex and require the services of two experienced laparoscopists.
U.S. Pat. No. 5,279,548 teaches a method for use in a peritoneal or pelvis surgery, in which a funnel-like membrane introduced into the body cavity is positioned vertically below the organ to be resected, allowing the resected tissue to fall into the membrane.
WO 97/17021 discloses a device for retrieving tubular parts such as stents from blood vessels. The gripping members of the device are provided with hooked ends adapted for engaging the stent.
U.S. Pat. No. 5,196,003 teaches a surgical instrument for endoscopic surgery having an elastically deformable suction cup communicating with a rubber bulb, whereby a suction effect can be applied to retain resected tissues.
WO 97/26828 discloses a laparoscopic instrument for handling parencynmatous and cavum organs. The device is provided with a funnel-like suction cup tiltably articulated to a tubular member and serving to retrieve resected tissue. The assembly is a single unit, and the suction cup cannot be moved independently of the retrieval member.
U.S. Pat. No. 5,417,697 teaches a polyp retrieval assembly comprising a cauterizing loop and a cup-shaped web member for retrieving resected tissue. The assembly is a single unit, and the web member cannot be moved independently of the retrieval member.
It is thus one of the objects of the present invention to provide a mouthpiece introducible into a body cavity for acquisition and retention of a resected biological specimen by vacuum suction.
It is a further object of the present invention to provide a pouch that is self-closing after being introduced into a body cavity, thereby entrapping a resected biological specimen for retrieval.
It is yet another object of the present invention to provide a relatively simple laparoscopic device that facilitates the vacuum capture and retention of a resected biological specimen, its entrapment in a self-closing pouch and its retrieval, and that can be operated by a single surgeon with no more than moderate experience in laparoscopy.
According to the invention, there is therefore provided a device for the acquisition and retention of resected biological specimens for retrieval from a body cavity, said device comprising a bowl-shaped mouthpiece made of an elastically resilient material; a first tubular member having a distal end connected to said mouthpiece and a proximal end connectable to a vacuum pump; characterized in that a plurality of openings are distributed over said mouthpiece, said openings leading to the distal end of said first tubular member, thereby facilitating the retention and retrieval of resected biological specimens by vacuum suction.
The invention also provides a closable pouch for the entrapment and retrieval of a resected biological specimen from a body cavity, said pouch comprising pliable, pre-shaped, membranous material attached at selected points substantially along meridian lines, to a plurality of pre-shaped, finger-like elements, said elements having distal ends and proximal ends, the proximal ends of said finger-like elements being connected to a tubular member slidably located inside an outer tubular member, characterized in that said finger-like elements exhibit different responses in different states, a first state response in which the distal ends of said finger-like elements flex away from each other, thereby causing the pouch to open and to engulf and entrap said specimen, and a second state response in which the distal ends of said finger-like elements flex toward each other, thereby causing the pouch to close, thereby retaining said specimen for retrieval.
The invention further provides a laparoscopic system for acquisition and retrieval of resected biological specimens, said system comprising at least three telescoping tubular members having distal and proximal ends, including an outer tubular member, an inner tubular member defining with said outer tubular member an annular space and being connectable at its proximal end to vacuum-producing means, and an intermediate tubular member slidably fitting said outer tubular member; a bowl-like mouthpiece having a front face and a rear face, for capturing and retaining a resected specimen, said mouthpiece being connected at its rear face to the distal end of said inner tubular member and being made of an elastically resilient material, said mouthpiece having a diameter in a non-deformed state exceeding the inside diameter of said outer tubular member but fitting into the distal end of said outer tubular member by elastic deformation; a plurality of finger-like elements fixedly connected to the distal end of said intermediate tubular member; a pouch made of pliable, membraneous material fixedly attached at a plurality of points to said plurality of finger-like elements; characterized in that, in the non-active, telescoped state of said system, said pouch, connected to said plurality of finger-like elements, is collapsed and disposed inside said annular space behind the rear face of said mouthpiece, and in the active state of said system, when said intermediate tubular member is pushed out of the outer tubular member, the distal ends of said finger-like elements first flex away from each other, thereby causing the pouch to open and to engulf said mouthpiece, and thereafter, the distal ends of said finger-like elements flex toward each other, thereby causing the pouch to close, entrapping and retaining said specimen for retrieval.
The invention still further provides a method for acquisition and retrieval of resected biological specimens, using the laparoscopic system described above, the method comprising the steps of introducing the distal end of the telescoped device into the body cavity; pushing out the inner tubular member, thereby removing the mouthpiece from the outer tubular member and causing said mouthpiece to assume its full diameter; actuating the vacuum-producing means and moving mouthpiece to a location in close proximity to the specimen to be resected, causing the resected specimen to cling to said mouthpiece; pushing out the intermediate tubular member, thereby causing the distal ends of finger-like elements to emerge from the annular space between the outer tubular member and the inner tubular member, said finger-like elements carrying along and opening up the pouch attached to them for engulfing the specimen retained by said mouthpiece; allowing the distal ends of said finger-like elements to close over said mouthpiece, thereby closing the pouch over said specimen, and withdrawing the device from the body cavity.
The invention will now be described in connection with certain preferred embodiments with reference to the following illustrative figures so that it may be more fully understood.
With specific reference now to the figures in detail, it is stressed that the particulars shown are by way of example and for purposes of illustrative discussion of the preferred embodiments of the present invention only, and are presented in the cause of providing what is believed to be the most useful and readily understood description of the principles and conceptual aspects of the invention. In this regard, no attempt is made to show structural details of the invention in more detail than is necessary for a fundamental understanding of the invention, the description taken with the drawings making apparent to those skilled in the art how the several forms of the invention may be embodied in practice.